Broadcast 3037 Dr. Valerie Martindale

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Guest: Dr. Valerie Martindale; Co-host Dr. John Jurist; Topics: We discussed Dr. Martindale's to letters to the Aerospace Medical Association members as her President's Letters. For the first half of our 63 minute program, we focused on her Oct. 2017 letter, "When Does Practice Change." For the second part of the 63 minute program, we focused on her Dec. 2017 letter, "The Gene Therapy Frontier in Aerospace Medicine." Links for downloading both letters can be found on our blog for this show. Please note my correction post with the right URL for her gene therapy paper. Please direct all comments and questions regarding specific Space Show programs & guest(s) to the Space Show blog which is part of archived program on our website, www.thespaceshow.com. Comments and questions should be relevant to the specific Space Show program. Written Transcripts of Space Show programs are a violation of our copyright and are not permitted without prior written consent, even if for your own use. We do not permit the commercial use of Space Show programs or any part thereof, nor do we permit editing, YouTube clips, or clips placed on other private channels & websites. Space Show programs can be quoted, but the quote must be cited or referenced using the proper citation format. Contact The Space Show for further information. In addition, please remember that your Amazon purchases can help support The Space Show/OGLF. See www.onegiantleapfoundation.org/amazon.htm.

Please note that we experienced a brief period of poor audio quality (about 12.5 minutes) at the start of the program. Fortunately, the problem was corrected for the balance of our program. Dr. Jurist and I welcomed Dr. Martindale to The Space Show and Dr. Jurist, a lifetime member of the Aerospace Medical Association, told us why he sent me Dr. Martindale's October letter to the membership, explaining why he believed it to be an excellent topic for a Space Show discussion. In discussing "Why Does Practice Change" one should note her summary (I read the final sentences on air) which said "Perhaps most difficult of all, we need to somehow cultivate the ability to differentiate knowledge from the illusion of knowledge." Boy, does this ring true for me as having hosted The Space Show for nearly 17 years! While Dr. Martindale cited many medical examples in her one page letter to the membership, we expanded the comparisons on air to the aerospace industry. Our guest talked about the problems caused by bias in the research and in the analysis. In addition, we talked about the problem of the small sample size in the aerospace industry. While our guest provided us with some methodology tools to attempt to counter the small sample size, it remains a problem for aerospace medicine research. Also discussed were cultural differences in researchers and methodologies. Our guest pointed out the need and benefit for being exposed to and listening to other perspectives, including differences in cultural perspectives. Valerie talked about rules and the citation index along with peers and peer review. In medicine, she pointed out problem areas when patients are blamed via self-monitoring such as with diet. She said blaming stress was also a problem. Don't miss all of her comments in this area. Before moving on to gene therapy for aerospace for the second part of our program, our guest said a good BS Detector class would be a good thing.

During the second part of our discussion, we turned to Dr. Martindale's December 2017 letter to the Aerospace Medical Association membership titled "The Gene Therapy Frontier in Aerospace Medicine." Our guest led off this segment as she did in her letter stating that we were on the verge of advances and changes in medicine that will be just as fundamental as were the initial discoveries of tools such as vaccinations, antibiotics, and other innovative treatments that today we consider routine. She mentioned gene therapies in the approval state, FDA progress in the area, what was going on in Europe and elsewhere, so much so that gene therapy was becoming part of the landscape. She cited as an example, laser eye surgery. Another example was gene therapy to correct color blindness. She easily extrapolated from the successful animal models to being able to do this for humans, then questioned what this may mean ethically and in terms of human performance, capability, even eligibility for something. We talked about the potential for gene therapy for radiation & micro gravity mitigation with human spaceflight as well as people simply wanting to be genetically modified to they can live in space.

Ethical boundaries came up and were a part of our discussion. This also brought into play the issue of informed consent. I asked about Crisper gene editing using CF and she talked about the progress being made in this area for an actual cure with Huntington's Disease that was very close at hand. One of the ethical questions she addressed was the issue of the gene therapy, whatever it maybe and whatever form it may take, being reversible. Don't miss this reversible discussion.

Space settlements came up again, this time regarding children and fetal development. Our guest and co-host said that developments in these fields were moving fast, faster than our questions and concerns were being answered. Dr. Martindale's letter talked about the issue of hypoxia for pilots. Could one be genetically "fixed" so that this was not a problem. Valerie said this issue was complicated because of pressure concerns. Again, don't miss this discussion. In addition, we talked about differences among people that already tolerate high altitude and lower pressure plus exposure to more solar radiation. The question was why and that needs more study.

Adrian sent in questions regarding p53 genes in elephants and the fact that they don't get cancer given they have so many more copies of p53 than humans. Could humans be genetically modified to have more p53 genes to become immune to cancer as is the case with elephants? This opened the door for Valerie to talk about cancer, exchanging DNA, RNA, p53 and even the possibility that some cancers might be caused by infections. She had much to say about cancer, gene modification or editing, p53, elephants, and people's cancer risk so don't miss it.

I fielded an email from a Tucson listener asking for the reasons for this type of research. Paul especially wanted to know if it was all academic, university and medically oriented research. If so, what was the reason for the DOD and military interest in it. Our guest said medical, university, academic, and NASA type organizations were all related to one another in the research fields. Regarding the military and DOD, her answer was most interesting so don't miss it. Tease: bioweapons but possibly not what you think. Doug called to ask about a future population on the Moon or Mars regarding radiation or even microgravity. He wanted to know about the idea of adaptation over natural selection. They had an interesting discussion and I asked Doug to post s clarification of his question on the blog. We took the last question from Adrian who said in response to a possible infectious cause of cancer, that "in the case of HPV 16, 31 etc. these are cancer causing viruses. Also Helicobacter bacteria are associated with stomach cancer. So organisms that infect humans can cause cancer." Our guest agreed with Adrian.

Please post your comments/questions on TSS blog for this show. You can reach Dr. Martindale or Dr. Jurist through me.

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